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TACO Spotlight

TACO Spotlight. Issue 1. Agenda. Who is “The Accountable Care Organization, Ltd ” (TACO) What is an ACO What it must accomplish Notice to the Patients about “The ACO” Impact to the Office Introduction to the Quality Program. The Accountable Care Organization Ltd.

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TACO Spotlight

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  1. TACO Spotlight Issue 1

  2. Agenda • Who is “The Accountable Care Organization, Ltd” (TACO) • What is an ACO • What it must accomplish • Notice to the Patients about “The ACO” • Impact to the Office • Introduction to the Quality Program

  3. The Accountable Care Organization Ltd • Entered into 3 year Contract with CMS on behalf of MHP to manage quality, patient satisfaction, and costs for Medicare FFS patients • Owned by MHP Physicians • CMS Triple Aim: “Better Quality, Lower Cost, Better Outcomes” • Contract requires meeting 33 Quality Measures

  4. Beneficiary Communication • Who? • Medicare Fee for Service Patients seen in a MHP practice not participating in another Medicare program (MA) or ACO. • Why? • This allows the ACO to receive Medicare claims data so the ACO can assess the total quality and cost of care on its attributed population.

  5. Data Sharing Notification • CMS Approved Letters will be mailed to all attributed beneficiaries we located. • Examples are part of the packet • TACO might ask for your offices help locating patient contact information on beneficiaries • We will process and store the elections • We will request the data in respect of the beneficiaries preferences

  6. Beneficiary Questions • Fee-for-service Medicare patients who see providers that are participating in a Medicare ACO maintain all their Medicare rights, including the right to choose any doctors and providers that accept Medicare.

  7. Impact to your Office • Primary Care Physicians • Your office is an exclusive participant in TACO • Cannot participate in another CMS ACO contract • Specialist • Your office is a participant in TACO • Your office may have patients attributed to you as a primary care provider • Your office may participate with other contracted CMS ACO’s

  8. Impact at your Office • Required Communication to Patients • What you need to do • How to handle problems • Required Information for use at your Office • Posters and/or Placards • Documentation of Point of Care Communication

  9. Quality Program • Required to completely & accurately report quality data each year • PYI is reporting only • PY2 & PY3 are based on performance • 33 Quality Measures • GPRO • CAHPS • Benchmarks for quality measures • Initial Audit(s) • Details forthcoming

  10. For more information • Phone numbers: 248-851-1419 • Web site: acoltd.org • CMS ACO Web site: medicare.gov/acos.html

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